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NPI Code Detail

MEDICARE: RITA LARAE VAN NORMAN LCSW

MEDICARE: RITA LARAE VAN NORMAN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker2142SD

General Provider Information

NPI Number : 1952433302
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA LARAE VAN NORMAN LCSW
Provider Business Mailing Address
First Line : 115 N 7TH ST STE 6
Second Line :
City : SPEARFISH
State : SD
Zip : 57783-2710
Country : US
Telephone Number : 605-645-0100
Fax Number : 605-717-1009
Provider Business Practice Location Address
First Line : 115 N 7TH ST STE 6
Second Line :
City : SPEARFISH
State : SD
Zip : 57783-2710
Country : US
Telephone Number : 605-645-0100
Fax Number : 605-717-1009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 02/21/2024

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Directions to “ RITA LARAE VAN NORMAN LCSW” Practice Location

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